Cardiorespiratory Dysfunction Induced by Brainstem Spreading Depolarization: A Potential Mechanism for SUDEP

Katayama, Pedro L.

doi:10.1523/jneurosci.3053-19.2020

Cited by 6 publications

(3 citation statements)

References 17 publications

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“…One advantage of DBA/2 mice is that their death is not associated with SE, and they exhibit sudden death immediately after AGS. Their death is a result of RA, leading to subsequent cardiac failure, in agreement with the findings obtained in many cases of human SUDEP ( 3 , 26 ). This distinct feature makes DBA/2 mice relevant SUDEP models.…”

Section: Dba/2 Mice As Relevant Models Of Human Sudepsupporting

confidence: 91%

“…Sudden unexpected death in epilepsy (SUDEP) is the most frequent cause of epilepsy-related death in drug-resistant epileptic patients, and repeated generalized tonic–clonic seizures (GTCSs) are associated with SUDEP, leading to insistent brain activity damage and enhanced sympathetic activation ( 2 ). Seizure activation can propagate to distinct subcortical structures via synaptic connections or, more likely, via spreading depression, which can alter brainstem activity and impair cardiorespiratory function ( 3 ). The risk of sudden unexpected death is estimated to be 20 times higher in epileptic patients than in the general population ( 4 ).…”

Section: Introductionmentioning

confidence: 99%

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Audiogenic epileptic DBA/2 mice strain as a model of genetic reflex seizures and SUDEP

Bosco,

Guarnieri,

Leo

et al. 2023

Front. Neurol.

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Epilepsy is a chronic neurological disease characterized by abnormal brain activity, which results in repeated spontaneous seizures. Sudden unexpected death in epilepsy (SUDEP) is the leading cause of seizure-related premature death, particularly in drug-resistant epilepsy patients. The etiology of SUDEP is a structural injury to the brain that is not fully understood, but it is frequently associated with poorly controlled and repeated generalized tonic–clonic seizures (GTCSs) that cause cardiorespiratory and autonomic dysfunctions, indicating the involvement of the brainstem. Both respiratory and cardiac abnormalities have been observed in SUDEP, but not much progress has been made in their prevention. Owing to the complexity of SUDEP, experimental animal models have been used to investigate cardiac and/or respiratory dysregulation due to or associated with epileptic seizures that may contribute to death in humans. Numerous rodent models, especially mouse models, have been developed to better understand epilepsy and SUDEP physiopathology. This review synthesizes the current knowledge about dilute brown agouti coat color (DBA/2) mice as a possible SUDEP model because respiratory arrest (RA) and sudden death induced by audiogenic generalized seizures (AGSs) have been observed in these animals. Respiratory/cardiac dysfunction, brainstem arousal system dysfunction, and alteration of the neurotransmitter systems, which are observed in human SUDEP, have also been observed in these mice. In particular, serotonin (5-HT) alteration and adenosine neurotransmission appear to contribute to not only the pathophysiological mechanisms of medication but also seizure-related respiratory dysfunctions in this animal model. These neurotransmitter systems could be the relevant targets for medication development for chronic epilepsy and SUDEP prevention. We reviewed data on AGSs in DBA/2 mice and the relevance of this model of generalized tonic–clonic epilepsy to human SUDEP. Furthermore, the advantages of using this strain prone to AGSs for the identification of possible new therapeutic targets and treatment options have also been assessed.

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Section: Dba/2 Mice As Relevant Models Of Human Sudepsupporting

confidence: 91%

Section: Introductionmentioning

confidence: 99%

Audiogenic epileptic DBA/2 mice strain as a model of genetic reflex seizures and SUDEP

Bosco,

Guarnieri,

Leo

et al. 2023

Front. Neurol.

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“…Drug-Resistant Focal Epilepsy (DRFE) has been related to unfavorable treatment outcomes, lower life quality, higher risk of seizure-related injuries, and increased risk of sudden unexpected death (SUDEP). Although cardio-respiratory brainstem dysfunction induced by bilateral tonic clonic seizures appears to be the most likely cause, the exact pathophysiology of SUDEP is still unknown [ 1 , 2 ].…”

Section: Introductionmentioning

confidence: 99%

Relation of Brain Perfusion Patterns to Sudden Unexpected Death Risk Stratification: A Study in Drug Resistant Focal Epilepsy

Chacón

García

Bosch-Bayard

et al. 2022

Behavioral Sciences

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To explore the role of the interictal and ictal SPECT to identity functional neuroimaging biomarkers for SUDEP risk stratification in patients with drug-resistant focal epilepsy (DRFE). Twenty-nine interictal-ictal Single photon emission computed tomography (SPECT) scans were obtained from nine DRFE patients. A methodology for the relative quantification of cerebral blood flow of 74 cortical and sub-cortical structures was employed. The optimal number of clusters (K) was estimated using a modified v-fold cross-validation for the use of K means algorithm. The two regions of interest (ROIs) that represent the hypoperfused and hyperperfused areas were identified. To select the structures related to the SUDEP-7 inventory score, a data mining method that computes an automatic feature selection was used. During the interictal and ictal state, the hyperperfused ROIs in the largest part of patients were the bilateral rectus gyrus, putamen as well as globus pallidus ipsilateral to the seizure onset zone. The hypoperfused ROIs included the red nucleus, substantia nigra, medulla, and entorhinal area. The findings indicated that the nearly invariability in the perfusion pattern during the interictal to ictal transition observed in the ipsi-lateral putamen F = 12.60, p = 0.03, entorhinal area F = 25.80, p = 0.01, and temporal middle gyrus F = 12.60, p = 0.03 is a potential biomarker of SUDEP risk. The results presented in this paper allowed identifying hypo- and hyperperfused brain regions during the ictal and interictal state potentially related to SUDEP risk stratification.

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Sudden Unexpected Death in Epilepsy (SUDEP)

Seth,

Khoo,

Arulsamy

et al. 2023

Handbook of Neurodegenerative Disorders

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Cardiorespiratory Dysfunction Induced by Brainstem Spreading Depolarization: A Potential Mechanism for SUDEP

Cited by 6 publications

References 17 publications

Audiogenic epileptic DBA/2 mice strain as a model of genetic reflex seizures and SUDEP

Audiogenic epileptic DBA/2 mice strain as a model of genetic reflex seizures and SUDEP

Relation of Brain Perfusion Patterns to Sudden Unexpected Death Risk Stratification: A Study in Drug Resistant Focal Epilepsy

Sudden Unexpected Death in Epilepsy (SUDEP)

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